More Articles

WASHINGTON — Most people covered by U.S. government health insurance for the poor visit hospital
emergency rooms for perceived emergencies, not for routine care, much like those with private
insurance, according to a study released yesterday.

Researchers said the study helps dispel the notion that poorer patients are clogging hospitals
for routine treatment — for a bad cold, for example — that others received at a lower cost in a
clinic or doctor’s office.

Patients on Medicaid — the insurance program for low-income people financed by the federal and
state governments — do visit emergency rooms at twice the rate of privately insured patients, said
the study by the non-partisan Center for Studying Health Systems, reflecting ongoing challenges in
finding alternative care.

But, like others, they go for urgent complaints of injuries and potentially serious problems
such as high fevers and breathing trouble, especially in children, the study said.

One in 10 Medicaid patients used an emergency room for non-urgent care, compared with about 1 in
14 for patients with insurance through their employer or purchased on their own, the study
showed.

“If you picked a Medicaid recipient and a privately insured patient out of an (emergency
department) waiting room and asked them both why they were there, the likelihood that they
described symptoms we would call non-urgent is pretty similar,” said Emily Carrier, a researcher
for the center.

The findings come shortly after the Supreme Court upheld President Barack Obama’s health-care
overhaul but allowed states to opt out of the provision opening Medicaid up to more people.

Several governors already have refused to implement the law, including its Medicaid expansion.
At the same time, some states are seeking ways to cut Medicaid costs, including discouraging
unnecessary and costly emergency-room use in the face of ongoing budget crunches.

Researchers at the center combed government statistics from the U.S. Centers for Disease Control
and Prevention’s National Center for Health Statistics for 2008, the most-recent data
available.

While some patients in emergency rooms initially reported serious symptoms, sometimes the
diagnosis turned out to be minor, according to the study.

Among Medicaid patients 12 or younger, more than half of all visits were for injuries, serious
breathing trouble, and common infections, the study said. Medicaid adults ages 18 to 64 also used
the emergency room most for a range of ailments including digestive issues, mental disorders and
injuries.